Monitor for oversedation side effects: slurred speech, sleeping, drowsiness.
Teach clients not to use alcohol which can potentiate the effects of valium.
Increased risk for congenital anomalies in the 1st trimester. Use with caution in women who become pregnant or who are pregnant.
It is excreted in breast milk and should be used with caution in nursing mothers.
Do not take with MAO inhibitors
Antacids may delay the absorption.
Used with caution in the elderly. Lower doses (one half to one third) should be
Slow IV administration of benzodiazepines. Valium/diazepam = 1 mg./minute.
For IM administration, give deeply in muscle to eliminate irritation.
PRN administration is preferable to regularly scheduled doses because of the tendency for addiction to occur. Even a 6 month course of taking Xanax/alprazolam can cause difficulty when trying to get patients off. The agitation and anxiety prevent some from wanting to quit taking the medication.
Tapering is a safe way to discontinue because of risk for seizures.
Benzodiazepine Antagonist (Flumazenil)
Side Effects: Drowsiness
Use: Short-term management of anxiety and sleep
Action: Depresses subcortical centers. Has no dependence, tolerance or intoxication. Can be used for indefinite periods and with patients who abuse substances.
Nursing implications: Give Vistaril deep IM using Z-track method
Non-benzodiazepine Antianxiety Agent: Buspirone (BuSpar)
Be aware that another Rx has a very similar name.